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01.12.2006 | Original Paper

Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain

verfasst von: Ivan A. Steenstra, Johannes R. Anema, Maurits W. van Tulder, Paulien M. Bongers, Henrica C. W. de Vet, Willem van Mechelen

Erschienen in: Journal of Occupational Rehabilitation | Ausgabe 4/2006

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Abstract

Objective: To evaluate the cost-effectiveness and cost-utility of a return to work (RTW) program for workers on sick-leave due to low back pain (LBP), comparing a workplace intervention implemented between 2 to 8 weeks of sick-leave with usual care, and a clinical intervention after 8 weeks of sick-leave with usual care. Design: Economic evaluation alongside a randomised controlled trial (RCT). Study population: Workers sick-listed for a period of 2 to 6 weeks due to LBP. Interventions: 1. workplace assessment, work modifications and case management). 2. physiotherapy based on operant behavioural principles. 3. usual care: provided by an occupational physician. Outcomes: The primary outcome was return to work (RTW). Other outcomes were pain intensity, functional status, quality of life and general health. The economic evaluation was conducted from a societal perspective. Outcomes were assessed at baseline (after 2–6 weeks on sick-leave), and 12 weeks, 26 weeks, and 52 weeks after the first day of sick-leave. Results: The workplace intervention group returned to work 30.0 days (95% CI=[3.1, 51.3]) earlier on average than the usual care group at slightly higher direct costs (ratio of 1 day: €19). Workers in the clinical intervention group that had received usual care in the first 8 weeks returned to work 21.3 days (95% CI= [−74.1, 29.2]) later on average. The group that had received the workplace intervention in the first 8 weeks and the clinical intervention after 8 weeks returned to work 50.9 days (95% CI=[−89.4, −2.7]) later on average. A workplace intervention was more effective than usual care in RTW at slightly higher costs and was equally effective as usual care at equal costs on other outcomes. A clinical intervention was less effective than usual care and associated with higher costs. Conclusion: The workplace intervention results in a safe and faster RTW than usual care at reasonable costs for workers on sick-leave for two to six weeks due to LBP.

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Titel: Economic Evaluation of a Multi-Stage Return to Work Program for Workers on Sick-Leave Due to Low Back Pain
verfasst von: Ivan A. Steenstra
Johannes R. Anema
Maurits W. van Tulder
Paulien M. Bongers
Henrica C. W. de Vet
Willem van Mechelen
Publikationsdatum: 01.12.2006
Verlag: Kluwer Academic Publishers-Plenum Publishers
Erschienen in: Journal of Occupational Rehabilitation / Ausgabe 4/2006
Print ISSN: 1053-0487
Elektronische ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-006-9053-0

Springer Medizin

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